Cornell Laboratory for Accelerator-based ScienceS and Education
I wish to participate as a guest in research at Cornell University for a limited period of time as an
employee of another institution or as a student. Any salary, benefits, or insurance related to
these research activities are provided by my home institution or others, and I understand that
Cornell does not provide any salary, benefits, or insurance for my activities under this
I understand that this Agreement provides access to the CLASSE research facilities, but does not
provide me with access to other Cornell facilities beyond access available to the general public
unless I specifically request an I.D. card from the CLASSE Administrative Office.
While a guest at Cornell, I will abide by CLASSE safety rules, and I agree to be bound by the
Cornell Campus Code of Conduct and other rules applicable to members of the Cornell
community or to the general public while visiting Cornell.
In exchange for my use of the facility, I agree to release, indemnify, and hold harmless Cornell
University for any and all claims or damages I may suffer related to my activities on campus,
other than those damages that occur as a direct result of the negligence of Cornell.
Printed Name _______________________________ Home Phone: ______________________
Home Address _________________________________________________________________
Start Date ___________ End Date ___________
Home Institution: __________________________________
Contact at CLASSE: ____________________________________